Recollection, familiarity, and behavioural pattern separation: A correlational study.

The relationship between recognition and pattern discrimination is not fully understood, and research on the relationships between these two processes is sparse. It has been generally assumed that pattern separation allows for recollection-based recognition. However, recent research has called this assumption into question. Therefore, the need for more research on this topic is evident. In the present study, we sought to investigate relationships between recollection- and familiarity-based recognition and behavioural pattern separation in healthy young adults. Participants (N = 146) completed two recognition tasks on a computer. The first was a word-pair recognition task involving unrelated and unitised word pairs (designed to measure recollection and familiarity, respectively), and the second was a mnemonic similarity test involving old, new, and similar (lure) object images (designed to measure behavioural pattern separation and completion). Correlation analyses showed that both recollection- and familiarity-based recognition were positively related to behavioural pattern separation. Regression analyses showed that, while controlling for familiarity, behavioural pattern separation was still predictive of recollection. However, while controlling for recollection, behavioural pattern separation was no longer predictive of familiarity. These findings support theoretical assumptions linking pattern separation to recollection.

Cumulative effect of loneliness and social isolation on health outcomes among older adults.

OBJECTIVES: Loneliness and social isolation are described similarly yet are distinct constructs. Numerous studies have examined each construct separately; however, less effort has been dedicated to exploring the impacts in combination. This study sought to describe the cumulative effects on late-life health outcomes. METHOD: Survey data collected in 2018-2019 of a randomly sampled population of US older adults, age 65+, were utilized (N = 6,994). Survey measures included loneliness and social isolation using the UCLA-3 Loneliness Scale and Social Network Index. Participants were grouped into four categories based on overlap. Groups were lonely only, socially isolated only, both lonely and socially isolated, or neither. Bivariate and adjusted associations were examined. RESULTS: Among participants (mean age = 76.5 years), 9.8% (n = 684) were considered lonely only, 20.6% (n = 1,439) socially isolated only, 9.1% (n = 639) both lonely and socially isolated, and 60.5% (n = 4,232) neither. Those considered both lonely and socially isolated were more likely to be older, female, less healthy, depressed, with lower quality of life and greater medical costs in bivariate analyses. In adjusted results, participants who were both lonely and socially isolated had significantly higher rates of ER visits and marginally higher medical costs. CONCLUSION: Results demonstrate cumulative effects of these constructs among older adults. Findings not only fill a gap in research exploring the impacts of loneliness and social isolation later in life, but also confirm the need for approaches targeting older adults who are both lonely and socially isolated. As the COVID-19 pandemic continues, this priority will continue to be urgent for older adults.

The impact of COVID-19 on older adults: Results from an annual survey.

OBJECTIVES: Assess well-being among older adults through secondary analysis measured during an annual survey in 2018, 2019, and 2020, to determine trends from before and during the COVID-19 pandemic. METHODS: Mailed surveys sent annually included measures related to various psychosocial factors. MAIN FINDINGS: Response rates were 29% in 2018, 25% in 2019, and 24% in 2020. Most respondents reported average or high resilience (89% 2018-2020), high purpose (64% in 2018 and 2019, 63% in 2020), moderate optimism (46% in 2019, 44% in 2020) and low stress (88% in 2019 and 2020). Reported loneliness increased 13% from 2018 to 2020. In 2020, only 45% reported high comfort with technology, decreasing with age (>75). PRINCIPAL CONCLUSION: Psychosocial well-being of respondents were doing well despite changes related to COVID-19. However, increased loneliness may negatively impact long-term health outcomes; thus, a focus on technology options to stay socially connected and access healthcare are needed.

The association of increasing resilience with positive health outcomes among older adults.

Our objective was to investigate three levels of resilience (low, medium, and high), identify associated characteristics, and measure the impact of increasing resilience on quality of life (QOL), healthcare utilization and expenditures, and preventive services compliance. The study sample was identified from adults age ≥65 who completed surveys during May-June 2019 (N=3,573). Other protective factors, including purpose-in-life, optimism, locus of control, and social connections, were dichotomized as high/low and counted with equal weighting (0 to 4). Among survey respondents, the prevalence of low, medium, and high resilience levels was 27%, 29%, and 44%, respectively. The strongest predictors of medium and high resilience included increasing number of other protective factors, lower stress, and no depression. Individuals with medium and high resilience had significantly higher QOL and lower healthcare utilization and expenditures. Resilience strategies integrated into healthy aging programming could be associated with improvements in QOL and/or healthcare utilization and expenditure outcomes.

The association of physical activity with loneliness, social isolation, and selected psychological protective factors among older adults.

The primary objectives were to investigate the association of physical activity levels with 1) loneliness and social isolation; 2) protective factors: resilience, purpose-in-life, and perception of aging; and 3) the impact of these factors on healthcare expenditure patterns across physical activity levels. The study sample was identified from adults age ≥65 who completed a health survey in 2018 or 2019 (N=6,652). Among survey respondents, the prevalence of low, moderate, and high physical activity levels was 29%, 31%, and 41%, respectively. Moderate and high physical activity were associated with 15%-30% lower likelihoods of loneliness and social isolation; and with 27% to 150% higher protective factors. In addition, physical activity was associated with the mitigation of increased healthcare expenditures associated with loneliness, social isolation, and low levels of protective factors. Thus, physical activity could serve as an intervention to reduce loneliness and social isolation, augment protective factors, and mitigate excess healthcare expenditures.

The association of resilience, social connections, and internal locus of control with pain outcomes among older adults.

Our objective was to investigate the hypothesis that psychological resources, including resilience, social connections, and internal locus of control, separately and in additive combinations, would be associated with selected pain outcomes: 1) days of opioid use and 2) medical/drug expenditures over 2 years. A mailed survey was sent to a stratified sample of older adults age≥65 with diagnosed back pain, osteoarthritis, and/or rheumatoid arthritis. Each of the resources was dichotomized as high/low and/or counted with equal weighting. Among respondents (N=3,131), the prevalence of mild/no and moderate/severe pain severity was 59% and 41%, respectively. As hypothesized, each resource was associated with lower levels of pain; additively, reported pain severity decreased as the number of resources increased. For moderate/severe pain, there was reduced opioid use among those with more resources; and, for mild/no pain, decreased medical/drug expenditures among those with ≥2 resources. Interventions that integrate psychological resources may enhance their effectiveness.

Reducing loneliness and improving well-being among older adults with animatronic pets.

BACKGROUND: Studies consistently demonstrate that older adults who are lonely have higher rates of depression and increased mortality risk. Pet ownership may be a solution for loneliness; however, challenges related to pet ownership exist for older adults. Therefore, researchers and practitioners are examining the use of animatronic pets to reduce loneliness. OBJECTIVE: To determine the feasibility of an animatronic pet program, and whether ownership of animatronic pets would decrease loneliness and improve well-being among lonely older adults. METHODS: Eligible individuals were identified as lonely through a prior survey. Participants were provided with the choice of an animatronic pet and completed T1/T2/T3 surveys. RESULTS: Attrition was high; 168 (63%) participants completed T1/T2 surveys, and 125 (48%) also completed a T3 survey. Post survey data indicated that loneliness decreased, while mental well-being, resilience, and purpose in life improved. Frequent interactions with the pets were associated with greater improvement in mental well-being and optimism. CONCLUSIONS: Animatronic pets appear to provide benefits for the well-being of lonely older adults. Future studies should employ randomized controlled designs examining the impact of animatronic pets.

The additive impact of multiple psychosocial protective factors on selected health outcomes among older adults.

Our objective was to investigate the additive properties of five psychosocial protective factors: purpose-in-life, resilience, optimism, internal locus of control and social connections. Self-reported psychological (depression, stress) and physical (health status, functionality) health outcomes and measured healthcare utilization and expenditures were included. The study sample was identified from adults age ≥65 who completed a health survey during May-June 2019 (N = 3,577). Each of the five protective factors was dichotomized as high/low (1/0) and counted with equal weighting. The protective factors were additive such that significant improvements in psychological and physical health outcomes were evident across factor subgroups: as the number of factors increased, health outcomes improved. The magnitude of the improvements was greatest between 0 and 1 factor. In addition, a significant linear trend for reduced healthcare expenditures ($1,356 reduction per factor added) was evident. Interventions promoting at least one protective factor would be beneficial for older adult populations.

The formation of source memory under distraction.

BACKGROUND: It is vital to select and process relevant information while restraining irrelevant information for successful retrieval. When multiple streams of information are concurrently present, the ability to overcome distraction is very crucial for processing relevant information. Despite its significance, the neural mechanism of successful memory formation under distraction remains unclear, especially with memory for associations. The present fMRI study investigated the effect of distraction due to irrelevant stimuli in source memory. METHODS: In the MR scanner, participants studied an item and perceptual context with no distractor, a letter-distractor, or a word-distractor. Following the study phase, a source recognition test was administered in which participants were instructed to judge the study status of the test items and context of studied items. Participants' encoding activity was back-sorted by later source recognition to find the influence of distractors in subsequent memory effects. RESULTS: Source memory with distractors recruited greater encoding activity in the left dorsolateral prefrontal cortex, and the bilateral inferior temporal gyrus/fusiform cortex, along with the left posterior hippocampus. However, enhanced activity in the left anterior ventrolateral prefrontal cortex and the left parahippocampal cortex predicted successful source memory regardless of the presence of a distractor. CONCLUSIONS: These findings of subsequent memory effects suggest that strong binding of the item-context associations, as well as resistance to interference, may have greater premium in the formation of successful source memory of pictures under distraction. Further, attentional selection to the relevant target seems to play a major role in contextual binding under distraction by enhancing the viability of memory representations from interference effects of distractors.

Biology, Germination Ecology, and Shade Tolerance of Alkaliweed (Cressa truxillensis) and Its Response to Common Postemergence Herbicides.

Alkaliweed (Cressa truxillensis) is a native perennial plant of the western USA and in California, they are found primarily in saline and alkaline soils. Lately, it has been observed in Central Valley pistachio, olive, and almond orchards as a problematic species. Very little information is available on the effect of environmental factors on germination, shade tolerance, and the response of this species to herbicides. Therefore, studies were conducted to assess the effect of environmental factors (water potential, salinity, and pH) on seed germination, the influence of shade (30% shade 70% shade, and no shade) on aboveground growth, and the response of alkaliweed to common registered post-emergent herbicides. Results showed that the seeds were moderately tolerant to drought but highly adapted to salinity and pH as germination occurred up to an electrical conductivity level of 20 dS m-1 and pH range of 5 to 9. Both shade levels reduced aboveground growth and formation of reproductive structures. None of the postemergence herbicides provided adequate control of the plants. Therefore, an integrated management plan needs to be developed for alkaliweed control in Central Valley orchards.

Inflammation, depression, and anxiety related to recognition memory in young adults.

Previous research suggests that common modifiable health risk factors (e.g., depression, anxiety, metabolic illness, inflammation) may have an impact on memory. In the present study, we sought to investigate relationships between a number of these health risk factors and two components of recognition memory (recollection and familiarity). Data were analyzed for 96 healthy young adults between 17 and 25 years old. Recollection and familiarity were measured using an associative recognition procedure involving unitized and unrelated word pairs, and regression analyses were used to relate recognition memory performance to physical health (inflammation via plasma IL-6 levels, central obesity via waste-to-hip ratio, and heart rate variability) and mental health (depression via CESD-R, stress via PSS, and state and personality trait anxiety via STAI) measures of modifiable risk factors. Together, these health variables predicted an additional 19% of the variance in recollection beyond what was accounted for by familiarity, and 15% of the variance in familiarity beyond what was accounted for by recollection. These effects were primarily driven by inflammation, depression, and trait anxiety, which were each significant (p < .05) independent predictors of recognition. Higher levels of depression and inflammation were related to worse recollection yet better familiarity. Higher levels of trait anxiety were related to better recollection but were not related to familiarity. These findings demonstrate complex relationships between these modifiable health risk factors and recognition memory. Future longitudinal and cross-sectional research is needed to further explore these relationships and determine whether or not poor health causes these changes in recognition.

Older Adults' Experiences in a Web-Based Intervention for Loneliness.

Background: Older adults may be vulnerable to loneliness due to natural and age-related transitions. Lonely older adults are at an increased risk of adverse health outcomes due to their loneliness, including cognitive decline, cardiovascular disease, and mortality. Objective: The purpose of this study was to explore the experiences of vulnerable older adults in a web-based loneliness intervention. Methods: Older adult participants in a web-based loneliness intervention (n = 24) participated in semi-structured interviews eliciting feedback about their experience in the program and perceived outcomes. Participants' responses were analyzed using qualitative content analysis. Results: Participants reported fewer negative perceptions of their social skills and future social interactions, gaining new social skills, improved relationships, and increased confidence to initiate and maintain social contact. Conclusions: Findings suggest the efficacy of combining a web-based loneliness intervention with cognitive behavioral therapy, and provide implications for future web-based interventions for older adult populations.

Loneliness, Social Isolation, and All-Cause Mortality in a Large Sample of Older Adults.

OBJECTIVES: Using data from a large random sample of U.S. older adults (N = 7982), the effect of loneliness and social isolation on all-cause mortality was examined considering their separate and combined effects. METHODS: The UCLA-3 Loneliness Scale and the Social Network Index (SNI) were used to define loneliness and social isolation. Cox proportional hazards regression models were performed. RESULTS: Among study participants, there were 548 deaths. In separate, adjusted models, loneliness (severe and moderate) and social isolation (limited and moderate social network) were both associated with all-cause mortality. When modeled together, social isolation (limited and moderate social network) along with severe loneliness remained significantly associated with mortality. DISCUSSION: Results demonstrate that both loneliness and social isolation contribute to greater risk of mortality within our population of older adults. As the COVID-19 pandemic continues, loneliness and social isolation should be targeted safely in efforts to reduce mortality risk among older adults.

11beta-HSD1 inhibition ameliorates metabolic syndrome and prevents progression of atherosclerosis in mice.

The enzyme 11beta-hydroxysteroid dehydrogenase (HSD) type 1 converts inactive cortisone into active cortisol in cells, thereby raising the effective glucocorticoid (GC) tone above serum levels. We report that pharmacologic inhibition of 11beta-HSD1 has a therapeutic effect in mouse models of metabolic syndrome. Administration of a selective, potent 11beta-HSD1 inhibitor lowered body weight, insulin, fasting glucose, triglycerides, and cholesterol in diet-induced obese mice and lowered fasting glucose, insulin, glucagon, triglycerides, and free fatty acids, as well as improved glucose tolerance, in a mouse model of type 2 diabetes. Most importantly, inhibition of 11beta-HSD1 slowed plaque progression in a murine model of atherosclerosis, the key clinical sequela of metabolic syndrome. Mice with a targeted deletion of apolipoprotein E exhibited 84% less accumulation of aortic total cholesterol, as well as lower serum cholesterol and triglycerides, when treated with an 11beta-HSD1 inhibitor. These data provide the first evidence that pharmacologic inhibition of intracellular GC activation can effectively treat atherosclerosis, the key clinical consequence of metabolic syndrome, in addition to its salutary effect on multiple aspects of the metabolic syndrome itself.

Safety Events Associated with Tramadol Use Among Older Adults with Osteoarthritis.

Tramadol is a low-level opioid increasingly recommended to treat moderate-to-severe acute and chronic pain. Although characterized as having fewer opioid-related adverse events, the longer term safety of tramadol use among older adults has not been thoroughly documented. Thus, the primary objective was to examine the risk of safety events associated with chronic tramadol use compared to other chronic opioid use or no opioids among older adults with osteoarthritis. Safety events considered included: ≥3 emergency room (ER) visits, falls/hip fractures, cardiovascular (CVD) hospitalization, composite safety event hospitalization, and all-cause mortality. The study population included older adults ages ≥65 years diagnosed with osteoarthritis and classified into new or continuing tramadol use, new or continuing other opioid use, or nonuse. Inclusion criteria included: 6-month pre period and up to 33 months post period. Tramadol, other opioid, and no opioid users were 1:1 propensity-matched providing study populations of 25,899 within each category; 72% were new chronic opioid users. Multiple logistic regression or Cox proportional hazard ratios were used to document risk. Generally, tramadol users had fewer adverse event risks compared to other opioid users but higher risks than nonusers. New users of tramadol or other opioids had higher risks than continuing users. Tramadol use was associated with increased risk of multiple ER utilizations, falls/fractures, CVD hospitalizations, safety event hospitalizations, and mortality (new users only) compared to nonuse. Thus, although tramadol use may be appropriately recommended within a pain management strategy for older adults with osteoarthritis, careful monitoring for adverse safety events is warranted.

COVID-19 Era Social Isolation among Older Adults.

Risk of COVID-19 exposure and more severe illness are serious concerns for older adults. Social distancing has worsened existing social isolation, with severe impacts on connectedness among seniors. The pandemic is threatening to cause an extended health crisis, with impacts including serious health consequences. Our primary purpose is to summarize emerging research describing the impacts of the pandemic on social isolation among older adults. A streamlined search was conducted to fit the scope of this literature review. Common research databases and mainstream resources and websites were utilized to identify research published or released in 2020 to align with the pandemic. Early research indicates that the pandemic has worsened social isolation among older adults. Social isolation has become urgent, as seniors have lost their usual connections due to social distancing. While safety measures are critical to prevent virus exposure, this approach must be balanced with maintaining social connectedness. The pandemic highlights the importance of social connections, with significant impacts on both community-living older adults and those in nursing facilities. Safety protocols have created a paradox of reduced risk along with greater harm. Consequently, adapted approaches are urgently needed to address the consequences of a long-term social recession.

Robotic Pet Use Among Community-Dwelling Older Adults.

OBJECTIVE: The primary purpose of this study was to explore the efficacy of robotic pets in alleviating loneliness for older adults. METHOD: Self-reported lonely individuals with AARP Medicare Supplement plans insured by UnitedHealthcare who participated in a program with a robotic pet (n = 20) were recruited to participate in semi-structured interviews. Participants were asked to provide feedback about their experiences interacting with a robotic pet, their perceptions about the potential impact on loneliness, and recommendations for improving the program. Interviews were audio-recorded and transcribed verbatim. Participants' responses were analyzed using qualitative content analysis. Constant comparison and consensus-gaining processes were used to develop categories that later formed representative themes. RESULTS: Seven themes emerged from analysis: Openness to Adoption of Robotic Pet, Reactions to Pet and its Attributes, Integration of Pet in Daily Life, Strategic Utilization and Forging New Connections, Deriving Comfort and Camaraderie, Advice for Future Users, and Recommendations for Enhancing Ownership Experience. Participants living alone, with fewer social connections and less active lifestyles, derived the most benefit from interacting with their pets. Common responses to pets included cuddling, petting, grooming, and sleeping with them. Some shared or loaned their pets, while others refused to loan their pets to interested peers. Most reported showing their pets to others, which helped some facilitate communication and social connections. CONCLUSION: Robotic pets may be an effective solution for alleviating loneliness in older adults, especially among those who live alone, have fewer social connections, and live less active lifestyles.

Older Adult Caregivers' Experiences in an Online, Interactive Mindfulness Intervention.

BACKGROUND: While today's older adults experience longevity, they often manage several chronic conditions and increasingly serve as informal caregivers for aging parents, children with life-long disabilities, and spouses. Older adult caregivers managing personal chronic illness often experience significant psychosocial hardships. OBJECTIVE: The primary purpose of this study was to explore the experiences of older adult caregivers in an online, interactive mindfulness intervention. METHODS: Self-reported older caregivers who participated in an online-based mindfulness program (n = 20) were recruited for semi-structured interviews. Participants were asked to provide feedback about any previous experience with mindfulness and/or meditation, hopes or goals held prior to the start of the program, desired expectations, motivation for joining, impressions of sessions, most beneficial topics, potential application of content, and any perceived effects. Participants' responses were analyzed using qualitative content analysis. RESULTS: Five themes emerged from the analysis: Managing the Comprehensive Effects of Caregiving, Openness to Meditation and Mindfulness, Course Engagement and Incremental Growth, Building Rapport through Shared Experiences, and Ongoing Application and Opportunities for Refinement. Participants reported both short-term post-exercise benefits such as increased calm, relaxation, and stress relief, as well as long-term positive outcomes. Notably, participants found the program's unique interactive feature to be particularly beneficial as a form of perceived social support. CONCLUSIONS: Caregivers for older adults may derive benefit and potentially experience reduced subjective caregiver burden as a result of participating in a Mindfulness-Based Stress Reduction (MBSR) program, particularly when the program is augmented with a self-compassion approach and perceived social support.

Antidiabetic activity of a highly potent and selective nonpeptide somatostatin receptor subtype-2 agonist.

Somatostatin inhibits both glucagon and insulin secretion. Glucagon significantly contributes to hyperglycemia in type 2 diabetes. Despite its function in the inhibition of glucagon secretion, somatostatin fails to reduce hyperglycemia in type 2 diabetes, due to a parallel suppression of insulin secretion. Five pharmacologically distinct somatostatin receptor subtypes (sst(1)-sst(5)) mediate the effects of somatostatin on a cellular level. Pancreatic A cells express sst(2), whereas B cells express sst(5). In this study, we describe a novel approach to the treatment of type 2 diabetes using a highly sst(2)-selective, nonpeptide agonist (compound 1). Compound 1 effectively inhibited glucagon secretion from pancreatic islets isolated from wild-type mice, whereas glucagon secretion from sst(2)-deficient islets was not suppressed. Compound 1 did not influence nonfasted insulin concentration. In sst(2)-deficient mice, compound 1 did not have any effects on glucagon or glucose levels, confirming its sst(2) selectivity. In animal models of type 2 diabetes in the nonfasted state, circulating glucagon and glucose levels were decreased after treatment with compound 1. In the fasting state, compound 1 lowered blood glucose by approximately 25%. In summary, small-molecule sst(2)-selective agonists that suppress glucagon secretion offer a novel approach toward the development of orally bioavailable drugs for treatment of type 2 diabetes.